Somers is a wonderful little town in Northern Westchester, NY. I have enjoyed many evenings and weekends sitting on the sidelines, or helping out on the soccer fields. Sitting there as a parent and as the Chief of Sports Medicine of a local academic practice I do look at these injuries from both perspectives. I have witnessed many injuries. Some could have been prevented, many of which could not. As I have discussed before, the loss of seasonality of sports participation is leading to a higher rate of ACL ligament tears in many of our children.
Sitting among other parents and speaking with the coaches, it is often that I hear misinformation or poorly formulated plans to manage this terrible injury in a young athlete.
ACL tears in growing children can be a devastating injury. The more severe the injury, and the more structures injured in combination with the ACL, the more likely these youngsters might have life long ongoing issues with their knee.
As I often advise patients, your first ACL surgery is where we have the best chance at restoring the function and stability of the knee. How can you determine who is best qualified to treat or reconstruct your little athlete’s ACL tear? We know that volume matters in ACL surgery. ACL surgery should be performed by those of us who perform many of these procedures each year. The average Orthopedist performs but a few each year. The complication rate of low volume surgeons can be nearly 4 times higher then a high volume surgeon.
Which graft or tissue should we use to restore the ACL in our child’s knee. To a large extent that will be determined by their age and how much growth they have left. You might also be offered an allograft option — that is a ligament from a cadaver. Initially it might sound appealing, but if you read the literature or attend our conferences the data you will see can be astounding. Allografts of cadaveric grafts can high a failure rate as high as 40% in children. Thus, allografts should be avoided, if possible.
The most important part of recovering from ACL surgery will ultimately be the rehabilitation. The physical therapy following an ACL reconstruction is of critical importance. Rehabilitation involves not only getting your child’s knee back into shape, but also concentrating on emotional issues surrounding their injury and recovery from an ACL injury.
In my position as the head of a large local sports medicine program I have read about the rise of ACL injuries in many sports which are no longer seasonal in nature. The year round participation is over-stressing our children. My local community of Somers in Northern Westchester NY is no different. I am witnessing many more injuries then I did a decade ago. Luckily our knowledge about the best way to reconstruct and rehabilitate these ACL injuries has improved … and in the right hands, your child has a 70-80% chance of getting back on the field.
Do your homework , do not be afraid to seek many opinions … this is not an emergency surgery.
Let us know if you have any questions.
